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Barbara Taylor, a noted historian and professor of humanities, has written a memoir of her long, and at times harrowing, psychoanalysis and psychiatric hospitalization. In The Last Asylum: A Memoir of Madness in Our Times, Taylor goes beyond a standard autobiographical account and links her personal history to the sociocultural history of the asylum movement of the past 150 years. She focuses on the implications of the closing of psychiatric hospitals and residential treatment programs using her experience as a patient in the public mental health system in Great Britain during its last days of long-term psychiatric hospital care. The failure of institutional psychiatric treatment of the past centuries and the equal failure to replace the hospital system with adequate local community care are examined with complex insight into the human cost of our centuries of inadequate and often inhumane care.
Benefiting from psychiatric hospital and residential treatment available to her when she needed it in the late 1980s and early 1990s, Taylor has a firsthand view of both the necessity and the imperfections of this system of care. Taylor's historical document and personal memoir is not the least bit sentimental—she neither idealizes nor demonizes the care she has received. She presents a well-metabolized account of her experience that was deep and painful, yet she manages to come out of her 21½ years of soul-searing—soul-searching analytic work with an appreciation for both what was helpful, what was harmful, and what was simply odd or ironic. As a psychoanalyst working in a psychoanalytic hospital, perhaps the last of its kind, I found Taylor's insight into the risks and benefits of psychoanalytic treatment and psychiatric hospital care wise and sobering.
Divided into three sections, the first part of the book addresses issues of personal and family history, the entry into psychoanalysis, and the steady decline that takes place over the first 7 years of a five-times-per-week p